A number of busy A&E departments have been plunged into a new crisis after several freelance doctors failed to show up for work today in a row over pay.

The locum doctors are needed in hospitals across the country to provide medical cover due to the failure to recruit enough permanent staff.

However, a pay cut , imposed from Friday, led to these doctors in at least four hospitals not turning up today.

The Irish Association for Emergency Medicine, representing full time emergency consultants, said they are seriously concerned at the development.

Earlier today it emerged that last month was the worst August on record for hospital overcrowding.

The locum doctors have seen their hourly pay rate cut from €40 to €34.

Traditionally these doctors have had a very good income but they are journeymen who work in different hospitals and are not pensionable.

The HSE said the cut was a bid to bring equity between the freelance and full time staff.

Patients are likely to face even long delays before getting medical attention if the stoppages continue or escalate.

A spokesman for the senior full-time consultants said: "The Association is acutely aware that in some hospitals the majority of medical staff are employed through Locum Agencies and in these hospitals the ED will cease to function in the absence of doctors.

"Clearly, questions need to be asked as to why it is that such a high proportion of the medical workforce are employed as locums and, in particular, why so many local graduates choose to work as locums rather than take posts on standard contracts."